Kuvunika ijosi ry'umugore ni igikomere gisanzwe kandi gishobora kwangiza abaganga babaga amagufwa, kubera amaraso make, ikibazo cyo kuvunika kutavuga rumwe na osteonecrosis ni kinini, uburyo bwiza bwo kuvura kuvunika kw'ijosi bw'abagore buracyavuguruzanya, intiti nyinshi zemeza ko abarwayi barengeje imyaka 65 y'amavuko bashobora gufatwa nk'indwara ziterwa na arthroplastique, kandi abarwayi bari munsi y’imyaka 65 y'amavuko bashobora gutorwa kugira ngo babone amaraso, kandi abarwayi bafite munsi y’imyaka 65 y'amavuko barashobora gutorwa kugira ngo babone uburyo bwo kuvura indwara. kuvunika kw'ijosi ry'umugore. Kuvunika kwijosi ryijosi ryigitsina gore bifite ingaruka zikomeye za haemodinamike, kandi kugabanya gufunga no gukosora imbere biracyari uburyo busanzwe bwo kuvura kuvunika subcapital kwijosi ryumugore. Kugabanuka neza bifasha guhagarika kuvunika, guteza imbere gukira kuvunika no kwirinda umutwe wa femorale femorale.
Ibikurikira nuburyo busanzwe bwo kuvunika ijosi ryigitsina gore kuvunika kugirango baganire uburyo bwo gukora gufunga-kwimura imbere imbere hamwe na screw.
Amakuru y'ibanze y'urubanza
Amakuru y'abarwayi: umugabo ufite imyaka 45
Ikirego: kubabara ikibuno cyibumoso no kugabanya ibikorwa kumasaha 6.
Amateka: Umurwayi yaguye ubwo yari arimo kwiyuhagira, atera ububabare mu kibuno cy’ibumoso no kugabanya ibikorwa, bidashobora koroherwa no kuruhuka, maze yinjira mu bitaro byacu avunika ijosi ry’igitsina cy’ibumoso kuri radiyo, maze yinjira mu bitaro ameze neza kandi afite umutima mubi, yinubira ububabare bwo mu kibuno cy’ibumoso no kugabanya ibikorwa bye, kandi ntiyigeze arya kandi ntiyigeze arya.
Examination Ikizamini cyumubiri (Kugenzura umubiri wose & Kugenzura inzobere)
T 36.8 ° C P87 gukubita / min R20 gukubita / min BP135 / 85mmHg
Iterambere risanzwe, imirire myiza, imyanya idahwitse, imitekerereze isobanutse, koperative mugupima. Ibara ryuruhu nibisanzwe, byoroshye, nta edema cyangwa guhubuka, nta kwaguka kwa lymph node yimbere mumubiri wose cyangwa mukarere. Ingano yumutwe, morphologie isanzwe, nta bubabare bwumuvuduko, misa, umusatsi urabagirana. Abanyeshuri bombi bangana mubunini no kuzenguruka, hamwe nurumuri rworoshye. Ijosi ryari ryoroshye, trachea yari hagati, glande ya tiroyide ntiyagutse, igituza cyari gifite uburinganire, guhumeka byagabanutseho gato, nta kintu kidasanzwe cyabaye kuri auscultation yumutima, imbibi z'umutima zari zisanzwe kuri percussion, umuvuduko wumutima wari 87 gukubita / min, inda yumutima yari ifite Qi, inda yari ifite uburibwe cyangwa yoroheje. Umwijima n'impyiko ntibyamenyekanye, kandi nta mpuhwe zari mu mpyiko. Diaphragms y'imbere n'inyuma ntiyasuzumwe, kandi nta bumuga bw'umugongo, ingingo zo hejuru n'amaguru yo hepfo y'iburyo, hamwe no kugenda bisanzwe. Imiterere ya physiologique yari ihari mugupima imitsi kandi reflexes ntabwo yatanzwe.
Nta kubyimba kugaragara kw'ibibero by'ibumoso, ububabare bugaragara bwagaragaye hagati yigitereko cy’ibumoso, kugabanya ububi bwo kuzenguruka bwo hanze bw’ibumoso bwo hepfo, ibumoso bwo hepfo ingingo ndende ndende (+), gukora ikibuno cyibumoso, kumva no gukora amano atanu yikirenge cyibumoso byari byiza, kandi gutembera kwa arterial dorsal kwamaguru byari bisanzwe.
Ibizamini by'abafasha
Filime X-ray yerekanaga: kuvunika ijosi ryigitsina gore subcapital kuvunika, kwimura impera yamenetse.
Ibindi bisuzumwa bya biohimiki, igituza X-ray, densitometrie yamagufa, hamwe na ultrasound yamabara yimitsi yimbitse yibihimba byo hepfo ntago byagaragaye ko bidasanzwe.
Gusuzuma no gusuzuma bitandukanye
Ukurikije amateka y’umurwayi w’ihungabana, ububabare bwibibero byibumoso, kugabanya ibikorwa, gusuzuma umubiri kumubiri wibumoso ugabanya ubumuga bwo hanze, ubworoherane bwikibuno bugaragara, ibumoso bwibumoso bwibumoso longitudinal axis kowtow ububabare (+), imikorere yibibuno byibumoso, hamwe na firime ya X-ray birashobora gupimwa neza. Kuvunika kwa trochanter birashobora kandi kugira ububabare bwibibuno no kugabanya ibikorwa, ariko mubisanzwe kubyimba kwaho biragaragara, aho igitutu giherereye muri trochanter, kandi impande zizunguruka zo hanze ni nini, kuburyo ishobora gutandukana nayo.
Umuti
Kugabanya gufunga no gufunga imisumari yimbere byakozwe nyuma yo gusuzuma neza.
Filime ibanziriza gutangira niyi ikurikira
Maneuver hamwe no kuzunguruka imbere no gukurura ingingo zanduye hamwe no gushimuta gato ingingo zanduye nyuma yo gusana na fluoroscopi byagaragaje gusana neza.
Igipapuro cya Kirschner cyashyizwe hejuru yumubiri mu cyerekezo cy ijosi ryigitsina gore kuri fluoroscopi, hanyuma hakozwe uruhu ruto ruto ukurikije aho iherezo rya pin riherereye.
Imiyoboro ngenderwaho yinjizwa mu ijosi ryigitsina gore ibangikanye nubuso bwumubiri mu cyerekezo cya pin ya Kirschner mugihe ikomeza kugana imbere ya dogere zigera kuri 15 hanyuma hakorwa fluoroscopi
Igice cya kabiri kiyobora pin cyinjijwe binyuze muri femorale spur ukoresheje icyerekezo kibangikanye nu munsi wicyerekezo cyambere pin.
Urushinge rwa gatatu rwinjijwemo rusa ninyuma yinshinge yambere ukoresheje ubuyobozi.
Ukoresheje ishusho yibikeri fluoroscopic kuruhande, pin zose uko ari eshatu za Kirschner zagaragaye ko ziri mwijosi ryumugore
Gucukura umwobo werekeza ku cyerekezo cya pin, ugapima ubujyakuzimu hanyuma uhitemo uburebure bukwiye bw'umusumari utoboye wasunitswe ku cyerekezo kiyobora, birasabwa gusunika mu ruti rw'umugongo rw'imisumari ya mbere, bishobora gukumira gutakaza reset.
Shyira mu zindi ebyiri zashizwemo umugozi umwe umwe hanyuma urebe unyuze muri
Imiterere y'uruhu
Filime isubiramo
Ufatanije n'imyaka umurwayi afite, ubwoko bwavunitse, hamwe nubuziranenge bwamagufwa, kugabanya gufunga imisumari yimisumari yimbere byakosowe, bifite ibyiza byo guhahamuka bito, byanze bikunze ingaruka zo gukosora, imikorere yoroshye kandi byoroshye kubyitwaramo neza, birashobora gukoreshwa nimbaraga zo kwikuramo, imiterere yubusa ifasha kwangirika kwimitsi, kandi igipimo cyo gukira kuvunika ni kinini.
Incamake
1 Gushyira inshinge za Kirschner hejuru yumubiri hamwe na fluoroscopi bifasha kumenya ingingo nicyerekezo cyo kwinjiza inshinge hamwe nurwego rwo gutema uruhu;
2 Amapine atatu ya Kirschner agomba kuba aringaniye, zigzag ihindagurika, kandi yegereye inkombe zishoboka, ibyo bikaba byafasha kuvunika no guhagarika kunyerera;
3 Hasi ya Kirschner pin yinjira igomba gutoranywa kumurongo wigitsina gore uzwi cyane kugirango umenye neza ko pin iri hagati y ijosi ryigitsina gore, mugihe inama yibipapuro bibiri byambere ishobora kunyerera imbere no gusubira inyuma hejuru yigitereko cyoroshye kugirango byoroherezwe kubahiriza;
4 Ntugatware pin ya Kirschner icyarimwe icyarimwe kugirango wirinde kwinjira mubutaka bwa arctular, biti ya drill irashobora gucukurwa mumurongo wavunitse, kimwe nukwirinda gucukura mumutwe wumugore, ikindi kikaba gifasha kwikuramo imisumari;
5 Imiyoboro idafite umwobo yinjiye hafi ya hafi hanyuma unyuze muri bike, suzuma uburebure bwurugero rwimvano nukuri, niba uburebure butari kure cyane, gerageza wirinde gusimbuza inshuro nyinshi imigozi, niba osteoporose, gusimbuza imigozi ahanini bihinduka gukosorwa kwimigozi, kuberako umurwayi ateganya gukosora neza imigozi, ariko uburebure bwuburebure bwikigereranyo ni bwiza cyane!
Igihe cyo kohereza: Mutarama-15-2024
